Predictors of mobility in community-dwelling women aged 85 and older

Abstract

Purpose: To describe changes in mobility measured with the Timed Up and Go test (TUG) from baseline to follow-up 9 years later, and to examine which of the demographic, physical performance and health variables measured at baseline were predictors of the TUG at follow-up in a sample of women aged 85 or older. Method: This prospective cohort study included 113 community-dwelling women with a baseline mean age of 79.5 years. TUG was measured at baseline and at follow-up. The following baseline measurements were used as predictors: demographics, step-climbing ability, functional reach, and health. Results: At follow-up 110 women had decline in the TUG. Mean TUG scores at baseline and at follow-up were 6.7 s (SD = 1.3) and 13.2 s (SD = 6.8) respectively. Higher age, higher BMI, poorer results on; functional reach, step-climbing and self-rated health were independent predictors of poorer TUG at the 9-year follow-up. Exhibiting sufficient strength to climb a step of 40 cm or more protected significantly against mobility decline. Improving balance measured by the functional reach test by 1 cm lowered the probability of major mobility decline by 7%. Conclusions: Our results suggest that to decrease the risk of mobility decline focus should be on strength, balance and nutrition.Implications for RehabilitationA great reduction in mobility, measured with the Timed Up and Go was observed at the 9-year follow-up. Thirty-nine percent of the community dwelling women aged 85 and above scored below average for their age group and are at risk for adverse outcomes.The amendable baseline predictors of poorer Timed Up and Go at 9-year follow-up were: higher BMI, poor step climbing capacity and poor balance. Exhibiting sufficient muscle strength and muscle power to climb a step of 40 cm or higher protected significantly against mobility decline. Improving balance measured by the functional reach test by 1 cm lowered the probability of mobility decline by 7%.To decrease the risk for mobility decline, exercise programmes should focus on muscle strength and balance.